A Discussion of Fractional CO2 Laser Skin Resurfacing (Matrix)

CO2 laser skin resurfacing is a technique that uses a laser to vaporize the surface layers of the skin. This allows softening or elimination of wrinkles, abnormal pigmentation, scars and other skin imperfections. Fractionated CO2 means the energy is delivered on a grid which I will demonstrate to you and is a modification which allows for much faster healing than standard CO2 and fewer complications in terms of changes of pigmentation or scarring. It also allows the benefits of carbon dioxide lasering to be used safely on the skin of the neck, chest and hands for texture, lines, color unevenness and sun damage.

The procedure is done in the office under local anesthesia (cream supplemented with nerve blocks) or with intravenous sedation depending on the extent of the area to be lasered and your preference. It takes 30 to 45 minutes. Each treatment gives you about a 30% to 50% improvement in texture, lines, and about an 80% improvement in age spots and pigmentary irregularities. Very rarely, a second treatment can be done 6-12 months after the first. You will also be able to decide how much down-time you prefer. If you prefer, we can give you two lighter treatments spaced apart by months instead of one stronger treatment. We will discuss your goals and time limitations together.

After the laser treatment, the skin is left moist with bland ointments until healed. The grid is originally visible and then sloughs off. There is swelling, oozing and crusting which heals in most cases within 3-7 days. This is followed by redness that usually fades to pink within 4 weeks. The light pink skin may occasionally last several months but is a sign of deep and more permanent resurfacing. The pinkness may be hidden by using an opaque foundation. During the healing phase, you must avoid the sun and use sunscreen daily to help prevent changes in the skin pigmentation for about 1-2 months. A bleaching compound may also be prescribed if you tend to hyper-pigment (darken) with skin injury.

Although complications are very rare, they can occur. These include:

  • Prolonged redness or itching
  • Milia (small whiteheads)
  • Temporary acne
  • Infection (viral or bacterial)
  • Changes in skin pigmentation (darker or lighter)

Please inform me of any previous facial cosmetic procedures, if you are pregnant or taking medications like Accutane, oral contraceptives, Retin-A, Alpha-Hydroxy or other acid creams, and if you have ever had fever blisters or shingles.

LET ME KNOW IF YOU SMOKE! Nicotine will slow your healing and increase your risk of scarring and infection. You need to be nicotine-free for two months before and one month after this procedure. Also, let me know if you have had pigmentary changes in response to skin injury or sun exposure or if you form thick scars or keloids.

It will be a pleasure to discuss laser skin resurfacing with you in my office. Please do not hesitate to contact me if I can be of further assistance (804-320-8545).